Category: Representative Cynthia Thielen

Representative Cynthia Thielen introduced legislation that would require a warning label on all opioid prescriptions that says “Caution: Opioid. Risk of overdose and addiction.” Though this is a small step, it is a step in the right direction for the Hawaii Opioid Initiative.

On the floor when the motion to recommit was made, Representative Cynthia Thielen said, “Article 14 of our Constitution requires all boards and commission members who wield significant discretionary or fiscal powers to file financial disclosure statements to promote transparency and accountability. It doesn’t matter whether these board and commission members are non-paid volunteers, they still wield significant discretionary or fiscal powers. This bill will require the redaction or the hiding of all financial amounts on the financial disclosure statements. So in other words, the public would be able to look at a meaningless document.” In summary, Rep. Thielen finds this bill to be unconstitutional and thus her motion to recommit it to the Judiciary committee. The motion failed, but the discussion continued. See video for the full discussion.

“House Republicans Announce Session Agenda to Make Hawaii More Affordable, Accountable, and Accessible”

HONOLULU, HAWAIʻI (January 19, 2018) – The Minority Caucus released their bill package today highlighting bills and resolutions that will make Hawaii more affordable, accountable, and accessible.

“Our charter schools are unique, creative, and out-of-the-box; they have different ideas. We’ve seen the trend in our state towards school choice as the charter school enrollment increased by 5%. HR 5 will help make our government more accessible to students and families who are seeking different public modes of education,” said Representative Andria Tupola, Minority Leader.

Representative Cynthia Thielen (District 50) used an acronym to describe HB 1732, “I’d like to take BITE out of food, Better If Tax Eliminated. Your family loses about $650 a year from taxes on food. We are standing with working families to keep their hard-earned money.”

“We are introducing a bill that will offer equal opportunity for everyone in our state to have their voices heard whether they live on the neighbor islands or in rural areas,” said Representative Lauren Matsumoto (District 45). “About 30% of Hawaii’s population lives on the neighbor islands and does not have the opportunity to testify in person. Offering audio and video technology to the neighbor islands would increase participation in our government and give us a perspective we have not heard in a long time.”

For more on the press conference, please see the attached dropbox link. For more on the bill package, please see the attached press packet. The Minority Caucus will be hosting a response to the Governor’s State of the State Address on Monday at 11am in the State Capitol Rotunda.

Death by a foreign nuclear attack threatens, but horrifyingly, the United States’ largest mass killer is American-made and -distributed. Its nationwide body count in 2016 alone — 64,000 — surpasses the total U.S. troops killed in the 20-year Vietnam War. Already in Hawaii, an escalating number of people die of it each year, outpacing fatal auto crashes.

Its name is opioid — a class of painkillers that doctors often prescribe — and Hawaii’s statistics show we’re on pace to suffer the rampant consequences from the deadliest drug crisis to ever hit American soil, spreading faster than the HIV epidemic at its peak.

Gripped by this reality, we must push and support the state’s bipartisan Hawaii Opioid Initiative newly released last month, two legislative bills that I am introducing and heightened public awareness to protect ourselves.

Don’t be fooled about opioid’s reach. A surge of newborns is now entering the world dependent on the overprescribed, highly addictive drug. It claims victims of all ages, ethnicities, genders and income. Its various forms and names include fentanyl, hydrocodone and oxycodone, commonly known by its brand name, OxyContin.

Why else does this drug crisis matter to Hawaii’s people? According to the Hawaii Opioid Initiative report:

• the amount of opioid painkillers prescribed nationally in 2015 was enough to keep every American medicated 24/7 for three weeks;

• in Hawaii, there are nearly 490,000 dispensed prescriptions for oxycodone and hydrocodone, potentially consumed by one-third of our state’s population;

• 66 percent of 56 overdose victims autopsied in Honolulu County in 2016 showed positive for opioid pain relievers other than morphine, codeine and methadone;

• oxycodone, oxymorphone, fentanyl and hydrocodone were among the most common opioids found in the above autopsy sampling, while fentanyl is up to 100 times more potent than morphine;

• it costs about $40,100 for each Hawaii hospitalization and every opioid-related overdose costs $4,050 on average per emergency department visit.

Legislation Is On The Way

This year, I am sponsoring House Bills 1602 and 1603.

HB 1603 requires that pharmacies and any outlets selling opioid drugs must provide a warning label of the risks that the medication carries beginning in August 2018. The label shall:

• convey in plain and simple language messaging like “WARNING: THIS DRUG IS AN OPIOID. THE USE OF AN OPIOID MAY RESULT IN AN ADDICTION TO OPIOIDS AND DEATH”;

• feature at least 14-point font;

• contain all-capital lettering; and

• be affixed to the drug container.

HB 1602 requires health insurers and health maintenance organizations to provide coverage and benefits for opioid dependence for a minimum of six months of inpatient and outpatient treatment beginning January 2019. This includes:

• no prepayment of medical expenses by patients during the first six months per plan year of benefits except for copayments, deductibles or co-insurance; and

• providing inpatient stays for the first 28 days without any insurer’s backdated or retroactive reviews of “medical necessity.”

Our No. 1 Killer

How did this painkiller lead to the worst drug crisis in American history?

The Sackler family — worth $14 billion in 2015 and ranked as one of the 20 wealthiest families in America by Forbes — developed OxyContin in the 1990s through its Connecticut-based Purdue Pharma business.

Simply put, the Sacklers’ enormous wealth is blood money, earned at the expense of millions of people — Hawaii residents included — who have fallen prey to drug addiction and accidental overdosing deaths.

UPDATE: The Sackler family issued this statement Thursday morning: Arthur M. Sackler passed away in 1987, eight years before Oxycontin existed. His brothers, Mortimer and Raymond, purchased his one-third option in Purdue Frederick from his estate a few months after his death. None of his descendants have had any involvement with, nor ownership of, Purdue Pharma or benefitted from the sale of Oxycontin in any way.

OxyContin’s addictive properties were apparently well-known to the Sackler siblings but they denied any knowledge. Their marketing campaign misinformed doctors about the risks.

As a result of the Sacklers’ alleged complicity and collusion, the attorneys general of 41 states — including Hawaii — joined a coalition that last September served subpoenas on the Sacklers’ Purdue Pharma and four other major opioid manufacturers as part of a multistate investigation.

Other manufacturers under investigation are Allergan, Endo, Janssen and Teva/Cephalon. Three distributors were also subpoenaed: AmerisourceBergen, Cardinal Health and McKesson. Other states have filed lawsuits against the manufacturers and distributors.

Waging war against opioids resembles the multipronged strategies and tactics that I executed with fellow legislators, backed by unrelenting pressure by citizens on the biggest tobacco makers in the 1990s. Eventually, smoking was banned in public. Similarly, we can defeat the deadly widespread effects of opioids.

Meanwhile, “make America great again” is an overused, diluted slogan and frankly, America hasn’t been great when it comes to drugs since opioids’ production in the 1990s and likely before then. Let’s make America clean, or as pre-opioid clean as possible. A nation must quash its worst drug epidemic before it can be great.

At this juncture, it’s up to us to take action, such as the 41 attorneys general and I are doing, because incomprehensively, the president did not declare this a “national emergency,” as he originally promised to do. Had he done so, we’d have quick federal funding at our disposal.

Join me in supporting legislation that safeguards us, keeping the participants in the governor’s opioid response plan accountable, getting educated about opioids and safer alternatives, advocating for ourselves when interacting with doctors; and pressing insurance carriers to do the right thing. Let’s stand together to end opioid misuse and dethrone the “unstable genius” of America’s largest makers and distributors of “death and addiction by prescription.”

This legislative session, Honolulu Mayor Kirk Caldwell lobbied hard for extending the general excise tax another decade to fund rail, already the most expensive public works project in state history.

Had the Legislature buckled to that pressure, we would have converted a disappointment into a disaster. After burning through a generous $1 billion contingency fund, the mayor offered no honest accounting for past mistakes, no serious pledge to reduce expenses and no reasonable concessions to economic reality.

Instead, he pinched the “too-big-to-fail” argument from Wall Street bankers and demanded yet another bailout from Hawaii taxpayers.

Last year, the Federal Transit Administration urged the Honolulu Authority for Rapid Transportation to consider “a smaller project of independent utility” within current budget constraints. It conditioned federal funds on cost containment, interim terminus or deferral of certain stations, or new investment. With characteristic obstinacy, Caldwell pursued only the last option by only a single means: raising taxes.

I support bringing the city center segment from Middle Street to Ala Moana down to street level. This sensible alternative would save about $4 billion and four years of construction, while sparing Honolulu’s waterfront from permanent visual blight. By running the trains sooner, we can also use passenger fares to defray some expenses.

Building a street-level portion would imaginatively and prudently combine the measures requested by the federal government. The city has always reserved this as a contingency option should cost overruns doom the original plan for elevated rail. We have now reached that juncture.

Tax increases in any form will only subsidize Caldwell’s reckless hubris and aggressive incompetence.

Saving taxpayer money is not simply a matter of expediency, but of fairness and principle. Extending the general excise surcharge shifts the burden to our poorest residents, who will pay more for groceries and other necessities. Increasing the hotel and accommodation taxes hobbles our state’s primary economic engine. Raising property taxes further inflates housing costs, while devastating seniors and middle-class families, whose homes are often their most significant investment.

Worst of all, tax increases in any form will only subsidize Caldwell’s reckless hubris and aggressive incompetence. No one has supervised this boondoggle longer than he has. Before running for mayor, Caldwell served as the city managing director from 2008 to 2010, the self-proclaimed “primary point person” for rail. On his watch, bloated red tape, numerous design changes and haphazard contract modifications drove costs skyward.

By January 2010, the FTA had already publicly questioned whether Honolulu could afford a $5 billion rail project. Following that report, Gov. Linda Lingle, an early supporter of elevated rail, warned that the city should revise its financing and construction plans to anticipate a federal funding shortfall.

“I don’t know another project except this one that has made no adjustment from a pre-recession to a post-recession proposal,” Lingle said at the time. But rather than return to the drawing board, Mayor Mufi Hannemann and Caldwell pressed heedlessly forward.

When launching his mayoral campaign two years later, Caldwell again dismissed legitimate concerns about cost and funding.

“The current $5.2 billion budget includes a very large contingency and adequate reserves for short-term financing,” he blithely claimed. “Reports that it will cost $7 billion or more are only scare tactics unsupported by anyone except tea party-style rail critics.”

Today, HART’s own cost estimates for the project stand at $10 billion. We can only expect this figure to increase. Construction has not even reached the halfway mark, and the costliest segment through the dense downtown corridor still lies ahead. On current trajectory, rail will probably wind up costing $13-15 billion.

Mile for mile, that’s roughly the cost of the Channel Tunnel connecting England and France (adjusting for inflation). But the “Chunnel” was among the most complicated engineering feats of the last century — 20 miles undersea — and running high-speed trains that could load cars onboard. Moreover, at Prime Minister Margaret Thatcher’s insistence, private shareholders funded the whole project.

By contrast, under the best case scenario, we will receive a slightly fancier version of the Pearlridge monorail at ruinous cost to ordinary taxpayers. Nor does this include the price for continuous maintenance and repair. Because HART acquired substandard material at premium rates, we have already seen cracked guideways and broken shims before the first train has left its station. Unless we correct course now, these problems will only accumulate and compound.

Enough is enough. Honolulu deserves responsibility, accountability and fairness. Let’s bring this project back down to Earth.

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About the Author

Rep. Cynthia Thielen is a member of House committees on Judiciary; Energy and Environmental Protection; Water and Land; and Ocean, Marine Resources and Hawaiian Affairs. She is also a member of the Women’s, Keiki, and Kupuna caucuses.